NCM 119 5th Examination Coverage

Planning

Planning is a management
function, concerned with
defining goals for the future
organizational performance
and deciding on the tasks
and resources to be used in
order to attain those goals.
 Planning | Principles of Planning

1. Principle of Contribution to
Objectives
2. Principle of Planning Promises
3. Principle of Efficiency
4. Principle of Primacy
5. Principle of Flexibility
6. Principle of Navigational
Change
 Planning | Principles of Planning

7. Principle of Commitment
8. Principle of Pervasiveness
9. Principle of Framework
10. Principle of Timing
11. Principle of Alternative
12. Principle of Limiting Factor
13. Principle of Competitive
Strategies
 Planning | Characteristics of Planning

1. Planning is goal – oriented.

2. Planning is looking ahead.
3. Planning is an intellectual process.
4. Planning involves choice &
decision making.
5. Planning is the primary function of
management
 Planning | Characteristics of Planning

7. Planning is all Pervasive

8. Planning is designed for efficiency.
9. Planning is Flexible.
 Planning | Types of Planning

1. Strategic Plan
• usually around 3 to 5 years
• long term in nature
• based on explicit assessments of
the competitive strands and
weaknesses of the organization
• usually prepared in the upper
levels of management
 Planning | Types of Planning

2. Operational Planning
• pertains to activities in specific
departments of an organization
• They are generally shorter in time
frame (e.g. one year)
• usually involve the middle and
lower level managers.
 Planning | Types of Planning

3. Continuous or Rolling Plans

• involves mapping out the day to
day activities.
• task of the staff nurse, who has to
devise and implement the nursing
care plan for the patients, altering
or modifying the plan as
necessary depending on the
needs and problems of the
patients and the unit where the
plan is applicable
 Planning | Elements of Planning

• Mission statement - concise

explanation of the organization's
reason for existence
• Vision statement - looks forward
and creates a mental image of the
ideal state that the organization
wishes to achieve
• Values Statement - core principles
that guide and direct the
organization and its culture
 Planning | Gantt Chart

show task and schedule

information. The Tasks are
numbered and listed vertically. A
bar shows the starting date and
projected completion date of each
task. Color or shading is sometimes
used to show how much of each
task has been completed. It is both
a management tool and
communications tool.
 Planning | Budgeting

Budgeting is defined as a
systematic financial translation
of a plan, the allocation of
scarce resources based on
forecasted needs for proposed
activities over a specified
period of time. It is a tool for
planning, monitoring, and
controlling cost and meeting
expenses.
 Planning | Types of Budget

1. Nursing Budget
2. Hospital Budget
3. Budget Plan
• Revenue budget
• Expense budget
• Capital budget
• Cash budget
 Planning | Barriers to Planning

• Inability to plan or inadequate

planning
• Lack of commitment to the planning
process
• Inferior information
• Focusing on the present at the
expense of the future
• Too much reliance on the
organization’s planning department
• Concentrating on controlled
variables
 Organizing

• Organizing involves assigning

tasks, grouping tasks into
departments, delegating
authority, and allocating
resources across the
organization. During the
organizing process, managers
coordinate employees, resources,
policies, and procedures to facilitate
the goals identified in the plan.
 Organizing | Classical Theory

Four Elements of Organizing

1. Division of Labor
2. Unity of Command
3. Authority and Responsibility
4. Span of Control
 Organizing | Humanistic Theory

Mintzberg’s Behavioral
Description - when jobs, conditions,
and expectations change, you're
continuously exchanging positions.
Henry Mintzberg, a management
expert and professor, observed this
and proposed ten basic roles or
behaviors that might be used to
categorize a manager's many
functions.
 Organizing | Humanistic Theory

Contingency Theory - а leаder's

efficаcy is determined by the
situаtion. Аccording to the
frаmework, there is no one best
leаdership style.
 Organizing | Types of Organizational Structure

1. Hierarchical Structure
2. Functional Structure
3. Matrix Structure
4. Flat Structure
5. Divisional Structure
6. Network Structure
7. Line Structure
8. Team – Based Structure
9. Circular Structure
10. Process – Based Structure
 Organizing | Types of Organizational Structure

Hierarchical Structure
• employees are grouped and
assigned a supervisor
• most common type of organizational
structure
 Organizing | Types of Organizational Structure

Functional Structure
• divided into groups by roles,
responsibilities or specialties.
 Organizing | Types of Organizational Structure

Matrix Structure
• resembles a grid in which
employees with similar skills
are grouped together and
report to more than one
manager.
 Organizing | Types of Organizational Structure

Flat Structure
• most levels of middle management
are removed so there is little
separating staff-level employees from
upper management
• Employees are given more
responsibility and decision-making
power without the usual hierarchical
pressures or supervision and can
often be more productive
• mostly used by small companies and
early-stage start-ups
• referred to as a “horizontal structure.”
 Organizing | Types of Organizational Structure

Divisional Structure
• organizations are split into divisions
based on specific products, services or
geographies
 Organizing | Types of Organizational Structure

Network Structure
• organizations are split into divisions
managers at an organization will
coordinate relationships with both
internal and external entities to deliver
their products or services
 Organizing | Types of Organizational Structure

Line Structure
• authority within the organization
flows from top to bottom and there
are no specialized or supportive
services
• one of the simplest types of
organization structure
• typically divided into departments
that are overseen and controlled
by a general manager, and each
department has its own manager
with authority over its staff
 Organizing | Types of Organizational Structure

Team-Based Structure
• employees are grouped into
skills-based teams to work on
specific tasks while all working
toward a common goal
• allows employees to move from
team to team as they complete
projects
• focuses on problem-solving and
employee cooperation.
 Organizing | Types of Organizational Structure

Circular Structure
• relies on hierarchy to depict higher-
level employees within the inner rings
of a circle and the lower-level
employees along the outer rings
• leaders do not send orders down the
chain of command, but rather
outward.
 Organizing | Types of Organizational Structure

Processed – Based
Structure
• organization is designed around the
flow of its processes and how the
duties performed by its employees
interact with one another. Instead of
flowing from top to bottom, this
structure outline services from left to
right.
 Organizing | Types of Healthcare Organization

1. Hospitals
2. Long – term Care Facilities
3. Ambulatory Care Centers
4. Home Healthcare Agencies
5. Free – Standing Clinics
6. Temporary Service Agencies
 Staffing

Staffing is the process of

assigning competent people to
fill the roles of designated for
the organizational structure
through recruitment, selection,
and development.
 Staffing | Staffing Pattern

• a plan that articulates how many and

what kind of staff are needed by shift
and day to staff a unit or department.
• can be generated by determining the
nursing care hours needed for a specific
patient or patients and then generating
the Full Time Equivalents (FTEs) and
staff-to-patient ratio needed to provide
that care
 Staffing | Staffing Pattern

Considerations in the
Development of a Staffing
Pattern:

1. Benchmarking
2. Regulatory Requirements
3. Skill Matrix
4. Staff Support
5. Historical Information
 Staffing | Staffing Pattern | Developing Staffing Pattern

Two Ways of Developing a Staffing Pattern

1. Determine the # of nursing care hours needed/patient
• Generating the full time equivalents of an employee
2. Determine the nurse-patient ratio in providing nursing care
• FTE – measure of work committed of full time
employee
• FTE = works 5 days/week, 8 hours/day
• 0.5 FTE = part time employee who works 5 days/2
weeks
 Staffing | Staffing Pattern | Patient Classification System

Patient Classification
System
• Measuring tool used to articulate
the nursing workload for specific
patient or group of patients over a
specific time.
• Patient Acuity – measure of
nursing workload that is generated
for each patient.
 Staffing | Staffing Pattern | Patient Classification System

Patient Care is Classified According to:

1. Self care or minimal care patients are capable of carrying ADL, e.g., hygiene,
meals etc.
2. Intermediate or moderate care requires some help from the nursing staff
with special treatments or certain aspects of personal care, e.g., patients
with IV fluids, catheter, respirator, etc.
3. Total care patients are those who are bedridden and who lack strength and
mobility to do average daily living. Ex: patients on CBR, immediate post-op,
with contraptions.
4. Intensive care patients are those who are critically ill and in constant danger
of death or serious injury. Ex: comatose, bedridden etc.
 Staffing | Staffing Pattern | Scheduling

Issues to consider in
Shifting Variations
scheduling staff:
• Traditional Shifting Patterns
1. Patient type and acuity
• 3 shift (8 hr shift)
2. Number of patients
• 12 hr shift
3. Experience of Staff
• 10 hr shift
4. Support available to the
• Weekend option
staff
• Rotating work shift
• Self-scheduling – staff makes Forty Hour Week Law – based on
RA5901
their own schedule • No work, no pay
• Permanent work shift • Entitled to 2-week sick leave
• Floaters – “on-call and off duty for 2 days
• Special Holidays – with pay
 Staffing | AONE Five Areas of Competency

AONE believes that managers at all

levels must be competent in:
I Communication and relationship-
building
II A knowledge of the healthcare
environment
III Leadership
IV Professionalism
V Business skills
 Staffing | AONE Five Areas of Competency

Communication and relationship-

building competencies include:
• Effective communication
• Relationship management
• Influence of behaviors
• Ability to work with diversity
• Shared decision-making
• Community involvement
• Medical staff relationships
• Academic relationships
 Staffing | AONE Five Areas of Competency

Knowledge of the healthcare environment includes:

• Clinical practice knowledge
• Patient care delivery models and work design
knowledge
• Healthcare economics knowledge
• Healthcare policy knowledge
• Understanding of governance
• Understanding of evidence-based practice
• Outcome measurement
• Knowledge of and dedication to patient safety
• Understanding of utilization/case management
• Knowledge of quality improvement and metrics
• Knowledge of risk management
 Staffing | AONE Five Areas of Competency

Leadership skills include:

• Foundational thinking skills
• Personal journey disciplines
• The ability to use systems thinking
• Succession planning
• Change management
 Staffing | AONE Five Areas of Competency

Professionalism includes:
• Personal and professional
accountability
• Career planning
• Ethics
• Evidence-based clinical and
management practice
• Advocacy for the clinical enterprise
and for nursing practice
• Active membership in professional
organizations
 Staffing | AONE Five Areas of Competency

Business skills include:

• Understanding of healthcare
financing
• Human resource management
and development
• Strategic management
• Marketing
• Information management and
technology
 Staffing | Core of Leadership Competencies

The "Fundamental 4"

leadership abilities are as
follows:
• Self-Awareness
• Communication
• Influence
• Learning Agility
SWOT Analysis